肉毒杆菌联合内镜扩张器治疗贲门失弛缓症的系统评价  

Systematic Review of Botulinum Toxin Combined with Pueumatic Dilation for the Treatment of Achalasia

作　　者：全胜源 唐梅文[1] 罗伟生[1] 张扬武[1] 王鲜庭 田惠芳[1] 

机构地区：[1]广西中医药大学,广西南宁530000

出　　处：《临床医学工程》2016年第8期1127-1130,共4页Clinical Medicine & Engineering

基　　金：国家自然科学基金项目(81260535)

摘　　要：目的系统性评价内镜下注射肉毒杆菌毒素联合内镜扩张器与单纯内镜扩张器法治疗贲门失弛缓症的临床疗效。方法通过检索式计算机检索全面收集关于内镜下注射肉毒杆菌毒素联合内镜扩张器治疗贲门失弛缓症的随机对照试验研究,对符合纳入研究的试验依据Cochrane协作网进行质量评价、资料数据提取,采用Rev Man 5.2软件进行系统评价。结果共纳入8个临床随机试验,包括297例患者。系统评价结果显示内镜下注射肉毒杆菌毒素联合内镜扩张器治疗贲门失弛缓症在改善食管动力学指标LESRR、降低食管钡剂存留高度具有优势,且具有较好的短期、长期疗效,操作简单方便,并发症少。结论内镜下注射肉毒杆菌毒素联合内镜扩张器治疗贲门失弛缓症可明显改善食管动力学指标、临床症状,建议在临床实践中依据患者病情选用。由于文献质量较低,仍需多中心、大样本的双盲随机对照试验进一步验证支持,以期作出更为严谨的系统评价,为内镜下治疗贲门失弛缓症提供更为可靠的证据。Objective To systematically evaluate the clinical effects of injection ofbotulinum toxin under endoscopy combined with pueumatic dilation and single pueumatic dilation for the treatment of achalasia. Methods With retrieving computers, random controlled clinical trials about ＂injection of botulinum toxin under endoscopy combined with pueumatic dilation for the treatment of achalasia＂ were comprehensively collected. Cochrane collaboration was used for quality assessment and data extraction of collected trials, and RevMan 5.2 software was used for systematical evaluation. Results Eight random controlled trials including 297 patients were enrolled. Systematical evaluation results showed that injection ofbotulinum toxin under endoscopy combined with pueumatic dilation for the treatment of achalasia had advantages in improving the esophageal motility index LESRR, reducing barium＇s remained height in esophagus, and had advantages of good short-term efficacy, good long-term efficacy, simple operation and fewer complications. Conclusions Injection of botulinum toxin under endoscopy combined with pueumatic dilation for the treatment of achalasia can effectively improve the esophageal motility index and clinical symptoms, which is recommended to be used in clinic according to patients＇ condition. Beside, the quality of literatures collected in this study is poor, which means that multi-center, double-blind, large sample random controlled clinical trials still should be taken for further verification and more rigorous systematic evaluation, so as to provide more reliable evidence for endoscopic treatment of achalasia.

关 键 词：肉毒杆菌 内镜扩张器 贲门失弛缓症 系统评价 

分 类 号：R573.7[医药卫生—消化系统]